Monday, August 13, 2012

I thought it fitting in this election year, when freedom of choice and rights to healthcare for women in the USA are again under attack, to note the birth date of Lucy Stone, born on this date in 1818. An American abolitionist and suffragette, she inspired Susan B Anthony, after Anthony heard her speak, to take up the cause for a woman’s right to vote. Women were granted the right to vote on August 18, 1920 by the 19th Amendment to the Constitution. Stone had been dead 27 years.

I often wonder what makes us so afraid of the liberty of others, what affront to our sense of self will occur should difference be allowed, let alone embraced. When I decided to switch from Family Practice to Psychiatry, and then become a psychoanalyst, a friend from high school thought I was making a politically incorrect decision for she erroneously thought mental health professionals unduly influence others to accept the status quo, to learn to live within a reality of constraint and even oppression, particularly for women, for example, to accept an unhappy marriage. Far from this type of acceptance or submission, in my view psychoanalysis helps people see a larger range of possibility. One female patient, in an unhappy marriage for over a decade, through analysis found the courage to imagine a life on her own without her abusive husband.

Lucy Stone advocated not just for the rights of woman to vote, but for the rights of women to divorce, to retain property and childrearing responsibilities after divorce, and, married herself, was the first American woman known to retain her own name after marriage. In other words, like psychoanalysts, she advocated for all people, including female persons, to live up to an panoply of potential based on inner resources and not on chromosomes.

Thursday, August 9, 2012

The best love letter I ever received was one word. Back in the days when people actually put pen to paper, and between the salutation “Dear Lycia” and the “Love, …” was scrawled in large, very large, letters, the single word, “YES.” It answered no asked question and therefore answered every possible question, evincing an openness to infinite possibility.

In an Angels and Airways song, Lifeline, the refrain goes:
"We all make mistakes.
Here's your Lifeline.
If you want it I want to."

But it sounds to me like singer Tom DeLonge is really singing:
We all make mistakes.
Here's all I’ve learned.If you want, I want to.
For me, If you want, I want to, is ‘yes,’ where ‘yes’ is the giving oneself over to the other (or to the experience) in a leap of faith, the leap of faith required to open oneself to the experience of the other in the therapeutic dyad.

I am reminded of the 1981 paper by Michael Eigen The Area of Faith in Winnicott, Lacan and Bion. (IJPsa., 62:413-433) [see also blog post of 2-14-09]: “For Winnicott, … creativity permeates psychic life and is involved in the very birth of self and other...” and, “Winnicott assumes life is primarily creative and in infancy this creativity unfolds …” Eigen elaborates Winnicott’s infant: “while the infant is living through creative experiencing, he neither holds on to anything, nor withholds himself.”[italics added, to emphasize the 'yes' of it] …“The true self feeling involves a sense of all out [italics added] personal aliveness …This connects with Bion's insistence that truth is necessary for wholeness and emotional growth….For Winnicott, the true self feeling is essentially undefensive...” [italics added].

Even Bob Hicok’s Confessions of a Nature Lover celebrates the ‘yes’ when he ends his poem:

"...that’s why we say
of real estate, location, location,
location, and of speech,
locution, locution, locution,
and of love, yes, yes, yes,
I am on my knees, will you have me,
world?"

Monday, August 6, 2012

The Runaway Bunny by Margaret Wise Brown, pictures by Clement Hurd

Difficult patients are difficult for their chronically intermittent, sometimes seemingly relentless, attacks on the work and on the therapist’s competence: “This isn’t working;” “Nothing has changed;” “Analysis is useless;” and, more pointedly, “You don’t care about me;” “You only care about the money;” “You don’t know what you’re doing;” “You suck!” Commonly, there are also frequent threats to quit analysis, often expressed with the threat of suicide.

To keep my balance and to survive (neither withdraw nor retaliate, in the Winnicottian sense), that is to persevere without thinking: “Here we go again;” “Who needs this anyway?”; or “Good riddance,” I recall the delightful children's book, The Runaway Bunny (1942) by Margaret Wise Brown, probably better known for her Goodnight Moon.

The Runaway Bunny is a felicitous analogy for working with patients who want us to believe that we are unimportant to them. The runaway bunny

said to his mother, “I am running away.”
“If you run away,” said his mother, “I will run after you.” …

“If you run after me,” said the little bunny,
“I will become a fish in a trout stream
And I will swim away from you.”

“If you become a fish in a trout stream,” said the mother,
“I will become a fisherman and I will fish for you.”

“If you become a fisherman,” said the little bunny,
“I will become a rock on the mountain, high above you.”

“If you become a rock on the mountain, high above me,”
said his mother, “I will become a mountain climber,
and I will climb to where you are.”

And so on for a crocus in a hidden garden, a bird flying away, a sailboat sailing away, his mother always finds a way to stay in connection with her little bunny.

“Shucks,” said the bunny, “I might just as well
stay where I am and be your little bunny.”

I can imagine this gives reassurance to an adventurous or angry, small child, that her/his mother will always come for it. With this on my mind, I hold the faith of commitment to the relationship and to the work.

Perhaps this attitude is implicitly conveyed, a balm of certitude for a patient who has experienced unpredictable or abandoning parents. Perhaps it is explicitly conveyed, “I will be here tomorrow at the appointed time.” Either way, it is my job, I think, to remain steadfast and keep faith when the patient conveys, with an onslaught of doubt and vituperation, her/his hopelessness, anger, or disappointment in me and in the work. A candidate asked, when I convey this attitude in class, if I were a masochist, or a saint. Neither, and I referred the candidate to Ghent’s 1990 paper on Masochism, Submission, Surrender.

Recently, after unrelenting, expressed hopelessness, a patient said to me, “I think I am doomed with or without you -- but I’d rather be doomed with you.” And after a few wiped tears, he added, “You’re the person I want to be doomed with,” and smiled.

Welcome!

Welcome to "Contemporary Psychoanalytic Musings," the blog of the Tampa Bay Institute for Psychoanalytic Studiesor, as it is conveniently known, T-BIPS. We invite you to post your comments on psychoanalysis and books, film, conferences, the media, art, theory, clinical situations, current controversies, social issues, and anything else as seen through a psychoanalytic lens. We look forward to a spirited dialogue with you.Lycia Alexander-Guerra, M.D.TBIPS PresidentGabcast! Welcome! #3

Tampa Bay Institute for Psychoanalytic Studies

13919 Carrollwood Village RunTampa, Florida 33618813-908-5080

About TBIPS

In 2005 a group of psychoanalysts & psychoanalytic psychotherapists convened to explore possibilities for meeting the educational needs of clinical professionals in the Tampa Bay area. Out of those discussions evolved a new institute, the Tampa Bay Institute for Psychoanalytic Studies. Consistent with the spirit of collegiality, openness, and diversity that inspired its development, the new Institute is non-authoritarian and democratic. Training programs utilize progressive and classical concepts which have been endorsed by contemporary critiques of psychoanalytic education. Believing that the capacity to think psychoanalytically best develops in an atmosphere of inquiry, open dialogue, and active participation the founding members sought to integrate these values into the structure of the new Institute and into the process of training. A precedent of collaboration and mutual respect for the contributions of all faculty and candidates was established enabling our mission to gain immediate representation in our actions.